Ron Banik DMD PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

RON BANIK DMD PC

Practice address

8720 Northpark Blvd
Suite B
North Charleston, SC 29406-9220

Phone

(843) 553-0911

Fax

(843) 553-0981

NPI assigned

Jan 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Manendu Banik, DMDNPI 1093870032

Title

Owner/Ceo

Phone

(843) 553-0911

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Carolina Family Dentistry Other name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manendu Banik, DMD

  • Dentist
  • N Charleston, SC
  • NPI 1093870032
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1376693572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8720 NORTHPARK BLVD",
            "address_2": "SUITE B",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069220",
            "telephone_number": "843-553-0911",
            "fax_number": "843-553-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8720 NORTHPARK BLVD",
            "address_2": "SUITE B",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069220",
            "telephone_number": "843-553-0911",
            "fax_number": "843-553-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RON BANIK DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "BANIK",
        "authorized_official_first_name": "MANENDU",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "843-553-0911",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9768",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Family Dentistry",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Carolina Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dentist in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.